Mukaino Masahiko, Ohtsuka Kei, Tanikawa Hiroki, Matsuda Fumihiro, Yamada Junya, Itoh Norihide, Saitoh Eiichi
Department of Rehabilitation Medicine, School of Medicine, Fujita Health University;
Faculty of Rehabilitation, School of Health Science, Fujita Health University.
J Vis Exp. 2018 Mar 4(133):57063. doi: 10.3791/57063.
Three-dimensional gait analysis (3DGA) is shown to be a useful clinical tool for the evaluation of gait abnormality due to movement disorders. However, the use of 3DGA in actual clinics remains uncommon. Possible reasons could include the time-consuming measurement process and difficulties in understanding measurement results, which are often presented using a large number of graphs. Here we present a clinician-friendly 3DGA method developed to facilitate the clinical use of 3DGA. This method consists of simplified preparation and measurement processes that can be performed in a short time period in clinical settings and intuitive results presentation to facilitate clinicians' understanding of results. The quick, simplified measurement procedure is achieved by the use of minimum markers and measurement of patients on a treadmill. To facilitate clinician understanding, results are presented in figures based on the clinicians' perspective. A Lissajous overview picture (LOP), which shows the trajectories of all markers from a holistic viewpoint, is used to facilitate intuitive understanding of gait patterns. Abnormal gait pattern indices, which are based on clinicians' perspectives in gait evaluation and standardized using the data of healthy subjects, are used to evaluate the extent of typical abnormal gait patterns in stroke patients. A graph depicting the analysis of the toe clearance strategy, which depicts how patients rely on normal and compensatory strategies to achieve toe clearance, is also presented. These methods could facilitate implementation of 3DGA in clinical settings and further encourage development of measurement strategies from the clinician's point of view.
三维步态分析（3DGA）被证明是评估运动障碍所致步态异常的一种有用的临床工具。然而，3DGA在实际临床中的应用仍然不常见。可能的原因包括测量过程耗时以及理解测量结果存在困难，测量结果通常以大量图表呈现。在此，我们介绍一种为便于3DGA在临床中应用而开发的对临床医生友好的3DGA方法。该方法包括简化的准备和测量过程，可在临床环境中短时间内完成，以及直观的结果呈现，以方便临床医生理解结果。通过使用最少的标记物并在跑步机上对患者进行测量，实现了快速、简化的测量程序。为便于临床医生理解，结果从临床医生的角度以图形方式呈现。使用李萨如图全貌图（LOP）从整体视角展示所有标记物的轨迹，以促进对步态模式的直观理解。基于临床医生在步态评估中的观点并使用健康受试者数据进行标准化的异常步态模式指数，用于评估中风患者典型异常步态模式的程度。还展示了一幅描绘脚趾离地策略分析的图表，该图表描述了患者如何依靠正常和代偿策略来实现脚趾离地。这些方法可促进3DGA在临床环境中的应用，并进一步鼓励从临床医生的角度开发测量策略。
